Summary :
Background: Pressure ulcers represent a major public health concern in nursing homes, where most residents have limited mobility. Although international guidelines recommend regular, individualised repositioning, their practical implementation remains insuffi-ciently documented and contextualised in relation to residents’ activities of daily living (ADLs).
Aim: To identify the position changes generated by ADLs among nursing home residents receiving pressure ulcer care, and to describe the influence of individual and organisational factors on time spent in bed and mobilisation frequency.
Method: This study used a Time-Driven Activity-Based Costing (TDABC) methodology under real-life conditions among nursing home residents. Daily mobilisations occurring during ADLs were identified and described for each resident receiving pressure ulcer care.
Results: Of 1,387 residents, 21% received pressure ulcer care, and 277 were included. Mobilisations dedicated specifically to pres-sure ulcer prevention concerned only 6.1% of residents. The median number of daily mobilisations was 11, and median time spent in bed was 16:25. Mobilisations predominantly occurred during ADLs related to hygiene, meals, and periods of rest. Individual and organisational factors appeared to influence both time spent in bed and mobilisation frequency.
Conclusion: ADLs represent valuable opportunities for mobilisation that should be considered when adapting and recontextualising preventive actions. Promoting personalised preventive strategies centred on residents’ wishes and needs remains essential.
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Article rédigé par :
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Jérémy Enez
Ergothérapeute, MSc
Formateur et responsable des enseignements de recherche en ergothérapie
IFPEK, Rennes
Doctorant, Laboratoire Arènes
Équipe RSMS, EHESP, Rennes
Living Lab Vieillissement et Vulnérabilités, Rennes
j.enez@ifpek.org
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Karim Jamal
Kinésithérapeute, PhD
Responsable département
des formations paramédicales
Université de Rennes
SMPR, CHU de Rennes
Centre investigation Clinique INSERM 1414, CHU de Rennes
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Carole Puil
Pédicure podologue, PhD
Responsable des enseignements de recherche en pédicurie-podologie
IFPEK, Rennes
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Romain Pichon
Kinésithérapeute, PhD
Coordonnateur scientifique,
équipe de recherche
IFPEK, Rennes
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Dominique Somme
Docteur en médecine
Professeur des universités
Service de gériatrie, CHU de Rennes
Directeur de recherche, EHESP, Rennes